Follow-Up Walsh Protocol Assessment — Methylation Pathway Panel with Report

This follow-up Walsh Protocol assessment is for established patients who have already completed an initial assessment and are now completing or submitting a Methylation Pathway Panel through Doctor’s Data or Genova Diagnostics.

This option is intended for patients who need a focused review of methylation pathway results, current symptoms, prior assessment findings, and response to the original nutrient or supplement plan.

The purpose of this follow-up is to determine whether methylation activity appears to be improving, blocked, overdriven, depleted, or requiring a change in the plan. This may be especially important for patients previously assessed with undermethylation, abnormal homocysteine, elevated SAH, low SAM, low SAM:SAH ratio, methylation inhibition, toxic burden, creatine demand, glutathione demand, or related biochemical patterns.

What This Follow-Up Includes

This service includes physician review of the submitted follow-up questionnaire or symptom update, review of the Methylation Pathway Panel, comparison with prior methylation or biotype findings when available, preparation of a written follow-up report, and an updated supplement or treatment plan.

A phone call is included to review the report, answer questions, and discuss next steps.

The fee covers physician review, methylation panel interpretation, written report, updated assessment, plan preparation, and phone discussion.

Labs Reviewed

This option is intended for follow-up review of a Methylation Pathway Panel performed through Doctor’s Data or Genova Diagnostics.

Markers reviewed may include:

• SAM
• SAH
• SAM:SAH ratio
• Methionine
• Homocysteine
• Cysteine or cystine
• Glutathione markers
• Related methylation, sulfur, and transsulfuration markers included on the submitted panel

The report may address methyl donor reserve, methylation efficiency, SAH inhibition, methionine status, homocysteine patterns, sulfur pathway demand, glutathione reserve, toxic burden indicators, creatine demand, mitochondrial burden, and other relevant findings from the submitted panel.

Undermethylation and Methylation Pathway Follow-Up

This option may be appropriate for patients previously assessed with undermethylation or suspected methylation impairment based on symptoms, whole blood histamine, homocysteine, SAM, SAH, SAM:SAH ratio, or related clinical patterns.

A methylation pathway follow-up may help determine whether the current plan remains appropriate, whether methylation support should be increased, reduced, redirected, or modified, and whether elevated SAH, low SAM, low methionine, low cysteine, or glutathione demand may be limiting progress.

In some cases, methylation concerns are not solved by simply adding more methyl donors. Persistent SAH elevation, low methionine reserve, toxic burden, gut fermentation, acidity, mitochondrial stress, creatine demand, and glutathione demand may all affect methylation pathway function and require a more targeted strategy.

When This Option Is Appropriate

This follow-up assessment is appropriate when the main purpose of the visit is to review a Methylation Pathway Panel and update the plan based on methylation, sulfur, glutathione, and related pathway findings.

It may be useful when symptoms have improved only partially, anxiety, depression, OCD, fatigue, insomnia, poor stress tolerance, cognitive issues, or detoxification sensitivity remain active, supplement tolerance has changed, or repeat testing suggests that the methylation plan needs to be adjusted.

This option may also be appropriate when prior labs showed low SAM, elevated SAH, low SAM:SAH ratio, elevated or abnormal homocysteine, low methionine, low cysteine, low glutathione reserve, or signs of increased methylation demand.

Lab Review Options

Labs ordered through Second Opinion Physician — $199

Select this option when the Methylation Pathway Panel is ordered through Second Opinion Physician. This allows the test to be reviewed efficiently in the expected format and interpreted in relation to the prior assessment and plan.

Patient providing outside methylation labs — $299

Select this option when the patient is providing a Methylation Pathway Panel or related methylation labs ordered through another physician, clinic, or laboratory source. Outside labs require additional review time because results may come from different laboratories, different dates, different formats, incomplete panels, or unrelated testing that must be sorted before the report can be prepared.

What This Follow-Up Does Not Include

This option does not include a full new patient assessment, comprehensive biotype panel review, broad toxic burden assessment, comprehensive functional medicine review, emergency care, psychiatric crisis care, medication management, or ongoing case management.

If the main purpose of the follow-up is to review updated zinc, copper, ceruloplasmin, whole blood histamine, vitamin D, homocysteine, CBC, CMP, or urinary pyrroles, the Follow-Up Walsh Protocol Assessment — Biotype Labs with Report option may be more appropriate.

If a broader review of organic acids, stool testing, mold-related testing, hormones, inflammatory markers, complex outside testing, or multiple unrelated lab panels is needed, a more comprehensive consultation option may be more appropriate.

Note

This follow-up assessment is for established patients only. The report and recommendations are based on the submitted symptom update, available lab results, prior information when available, and physician review.

Recommendations may need to be modified over time based on symptoms, tolerance, follow-up testing, and clinical response.